MAUDE Adverse Event Report: 700 ORTHOPAEDIC DRIVE PINN CAN BONE SCREW 6.5MMX30MM; BONE SCREWS AND PINS : SCREWS

Catalog Number 121730500

Device Problem Insufficient Information (3190)

Patient Problems Pain (1994); Swelling (2091); Burning Sensation (2146); Limited Mobility Of The Implanted Joint (2671)

Event Type  Injury  

Manufacturer Narrative

Product complaint # (b)(4).Attorney.If information is obtained that was not available for the initial medwatch, a follow-up medwatch will be filed as appropriate.

Event Description

Litigation alleges that the patient suffers from extreme pain.Doi: (b)(6) 2010; dor: none reported; (right hip).

Manufacturer Narrative

(b)(4).

Event Description

Pfs alleges swelling, burning sensation, and limited movement when sitting and standing.

Manufacturer Narrative

Pc-(b)(4).No device associated with this report was received for examination.The information received will be retained for potential series investigations if triggered by trend analysis, post market surveillance, or other events within the quality system.Depuy considers the investigation closed.Should additional information be received, the information will be reviewed and the investigation will be re-opened as necessary.If information is obtained that was not available for the initial medwatch , a follow-up medwatch will be filed as appropriate.

Manufacturer Narrative

Product complaint # (b)(4).No device associated with this report was received for examination.The information received will be retained for potential series investigations if triggered by trend analysis, post market surveillance, or other events within the quality system.Depuy considers the investigation closed.Should additional information be received, the information will be reviewed and the investigation will be re-opened as necessary.

• Brand Name: PINN CAN BONE SCREW 6.5MMX30MM
• Type of Device: BONE SCREWS AND PINS : SCREWS
• Manufacturer (Section D): 700 ORTHOPAEDIC DRIVE; depuy orthopaedics inc us; warsaw IN 46581 0988
• MDR Report Key: 7886503
• MDR Text Key: 120591568
• Report Number: 1818910-2018-69684
• Device Sequence Number: 1
• Product Code: LPH
• UDI-Device Identifier: 10603295010159
• UDI-Public: 10603295010159
• Combination Product (y/n): N
• PMA/PMN Number: K983014
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Manufacturer
• Source Type: consumer,other
• Type of Report: Initial,Followup,Followup,Followup
• Report Date: 08/23/2018

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Is this an Adverse Event Report?: No
• Is this a Product Problem Report?: No
• Device Operator: Health Professional
• Device Expiration Date: 02/28/2020
• Device Catalogue Number: 121730500
• Device Lot Number: 421814
• Was Device Available for Evaluation?: No
• Initial Date Manufacturer Received: 08/23/2018
• Initial Date FDA Received: 09/18/2018
• Supplement Dates Manufacturer Received: 10/12/2018; 10/18/2018; 10/18/2019
• Supplement Dates FDA Received: 10/12/2018; 10/19/2018; 11/05/2019
• Is This a Reprocessed and Reused Single-Use Device?: No
• Patient Sequence Number: 1
• Patient Outcome(s): Other
• Patient Age: 57 YR